SUBAKUT SKLEROZAN PANENSEFALİTLİ HASTALARDA KLİNİK GİDİŞAT VE PROGNOZ

Year 2015, Volume: 5 Issue: 2, 0 - 0, 01.06.2015

Sevgi Yimenicioğlu , Coşkun Yarar , Arzu Ekici , Ayten Yakut Kürşat Bora Çarman

Abstract

Amaç: Bu çalışmada Eskişehir Osmangazi Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı’nın Çocuk Nöroloji Ünitesinde yapılmıştır. 1998 ile 2011 yılları arasında Çocuk Nöroloji Bilim dalında SSPE tanısıyla izlenen 14 hasta retrospektif olarak incelenmiştir

Purpose: In this study we evalutaed fourten patients retrospectivley that had admitted to Eskişehir Osmangazi University pedıatric neurology departmen between the years 1998-2011.

 Gereç: Hastaların son nörolojik durumu nörolojik defisit indeksi(NDI) ile tespit edilmiştir. Hastaların aşılama durumu, klinik bulguları göz bulguları ve beyin görüntüleme yöntemleri değerlendirilmiştir. 

Material: Patient’s last neurologic state is examined by neurologic deficiıt index (NDI).  Vaccination state, clinical findings, visual findings, cerebral imaging findings are evaluated.

 Yöntemler: Hastalığı evrelerken Jabbour'un sınıflamasi kullanıldı. Hastaların BOS inclemesi yapıldı, BOS kızamık IgG ve IgM antikorları IFA yöntemi ile çalışıldı. Serum IgM kızamık antikoru, IgG kızamık antikoru ise ELİSA yöntemiyle çalışıldı.Jabbour classification is used for staging of the disease. Patients’ cerebrospinal findings are recorded, CSF IgM andI g G anticore titers are studied with IFA method. Serum IgM andI g G anticore titers are studied with ELISA method.

 Bulgular: Toplam 14 hasta çalışmaya alındı. Hastaların ortalama yaşı 7.8 idi. Başvuru şikayetleri düşme atakları, konuşma bozukluğu, myoklini, konvulziyon, kognitif değişiklik, gece korkuları, tremor, enkoprezis, davranış değişikliği, görme kaybı, senkop, ensefalopati tablosuyla ile başvurmuşlar.

Fourteen patients are included in the study. Patients median age was 7.8. Presenting symptoms were drop attacks, speech disturbances, myoclonus, convulsions, cognitive dysfunction, night terrors, tremor, encopresis, changes in behaviour, vision loss, syncope, encepaholpathy.   

Sonuç : Hastalar şikâyetleri başladıktan ortalama iki ay içerisinde hastaneye başvurmuştu, Şikayet başlangıcı ile tanı koyma arasında geçen süre 2 -4 ay  arasında idi. Hastalarımızdan 3 tanesine akut fulminan bir seyir gelişti, biri hastanede sepsis nedeniyle diğer 2’si taburculuktan sırasıyla 1.5,  2 ay sonra exitus oldular. 

Patients had admitted to the hospital within the two months of the symptom beginning. The duration between the beginning of the complaint and diagnosisi was 2-4 months. Acute fulminating progress was seen in three of our patients, one of our patients died because of sepsis, the other two died 1.5 and two months after discharge from the hospital retrospectively.  

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